Singh Yogen
Division of Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
Division of Neonatology, University of Southern California, Los Angeles, USA.
Expert Rev Med Devices. 2024 Apr;21(4):307-316. doi: 10.1080/17434440.2024.2334449. Epub 2024 Mar 25.
Traditionally echocardiography was used by pediatric cardiologists to diagnose congenital heart defects in neonates. Formalized neonatal hemodynamic fellowships have been established where neonatologists acquire advanced echocardiographic skills to gain anatomical, physiological, and hemodynamic information in real time and utilize this information in making a timely and accurate physiology-based clinical decision.
Differences between a comprehensive formal structural echocardiography, neonatologist performed targeted echocardiography and limited assessment on point-of-care-ultrasonography for specific indications have been covered. This article is focused at providing a comprehensive review of the status of echocardiography in the neonatal units, recent advancements and its future prospects in the neonatal intensive care units.
Comprehensive guidelines providing the scope of practice, a framework for training, and robust clinical governance process for the neonatologist performed targeted echocardiography have been established. In the last decade, echocardiography has emerged as essential vital bedside diagnostic tool in providing high-quality care to the sick infants in the neonatal units, and it has proved to improve the outcomes in neonates. It is now being considered as a modern hemodynamic monitoring tool. Advances in technology, machine learning, and application of artificial intelligence in applications of echocardiography seem promising adjunct tools for rapid assessment in emergency situations.
传统上,儿科心脏病专家使用超声心动图来诊断新生儿的先天性心脏缺陷。现在已经建立了正规的新生儿血流动力学进修项目,新生儿科医生可以在此获得先进的超声心动图技能,以便实时获取解剖、生理和血流动力学信息,并利用这些信息做出及时、准确的基于生理学的临床决策。
本文涵盖了全面的正规结构超声心动图、新生儿科医生进行的针对性超声心动图以及针对特定适应症的即时超声检查有限评估之间的差异。本文重点对新生儿病房超声心动图的现状、最新进展及其在新生儿重症监护病房的未来前景进行全面综述。
已经制定了全面的指南,规定了新生儿科医生进行针对性超声心动图的实践范围、培训框架和强有力的临床管理流程。在过去十年中,超声心动图已成为新生儿病房为患病婴儿提供高质量护理的重要床边诊断工具,并已证明可改善新生儿的治疗效果。现在它被视为一种现代血流动力学监测工具。技术、机器学习以及人工智能在超声心动图应用中的进展似乎是紧急情况下快速评估的有前景的辅助工具。